HCA Healthcare’s Equivalent Admissions Rose 3% in the Third Quarter
Key Facts
Equivalent admissions at HCA Healthcare’s same facilities rose 3.0% in the third quarter of 2026 from the same period a year earlier, while admissions at those facilities increased 2.7%, according to the company’s quarterly results statement. Revenue was $19.849 billion, up 3.6% from $19.161 billion in the third quarter of 2025, according to its quarterly report filed with the U.S. Securities and Exchange Commission. But net income attributable to the company fell to $1.579 billion from $1.643 billion a year earlier. Diluted earnings per share, by contrast, rose to $7.27 from $6.96. The results show a divergence between revenue growth and volumes in some services on one hand, and profitability pressure from patient mix on the other.
Activity indicators at the same facilities were mixed: emergency department visits rose 5.1% year over year in the third quarter, while inpatient surgeries fell 1.4% and outpatient surgeries declined 3.7%, according to HCA’s statement. The company said equivalent admissions increased 3.0%, exceeding the 2.7% growth in admissions, though that did not mean all service types rose uniformly. Admissions among uninsured patients stood out, with those cases at same facilities increasing 27.4% from the third quarter of 2025. HCA attributed this to the continuing effects of the enhanced premium tax credits expiring at the end of 2025 and administrative reforms, as well as a decline in the shift to Medicaid coverage. The company estimated that the shift in payer mix reduced its pretax income by about $400 million during the quarter, and linked the increase mainly to some patients losing coverage through health insurance marketplaces.
At the revenue level, quarterly growth slowed from the second quarter of 2026, when revenue rose 8.7% to $20.230 billion, according to HCA’s results for that quarter. Net income attributable to the company had then increased 2.8% to $1.699 billion, before posting a year-over-year decline in the third quarter. In the first nine months of 2026, revenue rose 5.5% to $59.188 billion, compared with $56.087 billion in the same period of 2025, according to the report filed with the SEC. These comparisons place the third-quarter performance in the context of continued revenue growth during the year, at a slower pace than the previous quarter and with a year-over-year decline in quarterly net income. The comparison does not include a company judgment on the reasons for the difference in pace between quarters; HCA put the third-quarter impact of payer mix on pretax income at about $400 million.
Alongside the results, HCA repurchased 7.230 million of its shares during the third quarter at a cost of $2.970 billion, according to the company’s statement. A further $4.240 billion remained available under its repurchase authorization as of September 30, 2026. The company also announced on October 27 that its board had approved a quarterly cash dividend of $0.78 per share. It said the dividend would be paid on December 29 to shareholders of record on December 15. These amounts place share repurchases and dividends alongside operating results for the same period, while the statement did not link the repurchase decision to any specific change in the stock’s performance.
Cash flows from operating activities totaled $4.461 billion in the third quarter, compared with $4.416 billion in the third quarter of 2025, according to HCA. Total debt stood at $50.493 billion on September 30, 2026. In its full-year guidance, the company said it expects its operating results to come in the upper half of the ranges in its 2026 estimates issued on July 14. It said the outlook is based on assumptions that include patient volumes, payer mix, health policies and inflation. HCA shares closed at $494.99 on November 6, 2026, according to EL7 data. The next cash dividend payment provides a disclosed milestone for shareholders in December, while the upper-half guidance remains the company’s latest operating estimate for the year.